{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T21:32:40Z","timestamp":1789421560437,"version":"build-2803163510"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T00:00:00Z","timestamp":1665619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Consortium for Advanced Research Training in Africa"},{"DOI":"10.13039\/100014515","name":"CARTA","doi-asserted-by":"crossref","award":["G-19-57145"],"award-info":[{"award-number":["G-19-57145"]}],"id":[{"id":"10.13039\/100014515","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100014515","name":"CARTA","doi-asserted-by":"crossref","award":["54100113"],"award-info":[{"award-number":["54100113"]}],"id":[{"id":"10.13039\/100014515","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Uppsala Monitoring Centre"},{"name":"DELTAS Africa Initiative","award":["107768\/Z\/15\/Z"],"award-info":[{"award-number":["107768\/Z\/15\/Z"]}]},{"DOI":"10.13039\/501100011858","name":"African Academy of Sciences","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100011858","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100014163","name":"Alliance for Accelerating Excellence in Science in Africa","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100014163","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100009250","name":"NEPAD","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009250","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Pre-treatment HIV drug resistance (PDR) may result in increased risk of virological failure and acquisition of new resistance mutations. With recently increasing ART coverage and periodic modifications of the guidelines for HIV treatment, there is a need for an updated systematic review to assess the levels of the PDR among adults newly initiating ART in Eastern Africa.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a systematic search for studies published between 1 January 2017 and 30 April 2022 in the MEDLINE Complete and CINAHL Complete, searched simultaneously using EBSCOhost, and Web of Science. To determine the overall PDR prevalence estimates, we extracted data from eligible articles and analysed prevalence estimates using Stata 14.2.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 22 eligible observation studies were selected. The studies included a total of 5852 ART-naive people living with HIV. The overall pooled prevalence of PDR was 10.0% (95% CI: 7.9%\u201312.0%, I2\u200a=\u200a88.9%) and 9.4% (95% CI: 7.0%\u201311.9%, I2\u200a=\u200a90.4%) for NNRTIs, 2.6% (95% CI: 1.8%\u20133.4%, I2\u200a=\u200a69.2%) for NRTIs and 0.7% (95% CI: 0.3%\u20131.2%, I2\u200a=\u200a29.0%) for PIs. No major integrase strand transfer inhibitors (INSTI)-related mutations were identified.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We observed a moderate overall PDR prevalence among new ART initiators in this study. PDR to NNRTIs is more prevalent, underscoring the importance of the current WHO recommendation for replacement of NNRTIs by INSTIs. PDR to NRTIs was low but notable, which warrants continuous surveillance of pre-existing resistance to the dolutegravir co-administered NRTI in Eastern Africa.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkac338","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T05:31:29Z","timestamp":1665639089000},"page":"3231-3241","source":"Crossref","is-referenced-by-count":17,"title":["Pre-treatment HIV-1 drug resistance in antiretroviral therapy-naive adults in Eastern Africa: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"77","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3134-3992","authenticated-orcid":false,"given":"Alex J","family":"Ntamatungiro","sequence":"first","affiliation":[{"name":"Ifakara Health Institute , Ifakara , Tanzania"},{"name":"Division of Epidemiology and Biostatistics, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana","family":"Kagura","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, University of the Witwatersrand , Johannesburg , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maja","family":"Weisser","sequence":"additional","affiliation":[{"name":"Ifakara Health Institute , Ifakara , Tanzania"},{"name":"Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Basel , Basel , Switzerland"},{"name":"Swiss Tropical and Public Health Institute , Basel , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1902-2683","authenticated-orcid":false,"given":"Joel M","family":"Francis","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, University of the Witwatersrand , Johannesburg , South 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